Basic Exam 3
What instrument is used most widely to quantify neurologic impairment?
Glasgow coma scale
Which of the following diseases may be suggested by the involvement of multiple nerve roots?
Guillain-Barré syndrom
What substance is responsible for carrying red blood cell oxygen on to the tissues?
Hemoglobin
Which of the following is the most common cause of a nerve root pathologic condition due to compression?
Herniated vertebral disc
Which of the following terms describes anemia due to low hemoglobin levels?
Hypochromic
What electrolyte abnormality is associated with irregular pulse, muscle weakness, and abdominal distention?
Hypokalemia
Which of the following terms is used to describe an abnormally low potassium level?
Hypokalemia
What is a decrease in tissue oxygenation called?
Hypoxia
Which of the following cranial nerves are evaluated with the gag reflex?
IX and X
What could cause tissue hypoxia with normal arterial oxygenation?
Inadequate cardiac output
What is believed to cause neutropenia in patients with viral infection?
Increased margination of neutrophils
What substance is a vital constituent of the heme portion of hemoglobin?
Iron
What can be said about the nucleus of the mature circulating red blood cell?
It is absent.
Which of the following is true regarding oxygen-carrying capacity?
It is decreased.
Which of the following is a true statement regarding the term hypoxemia?
It occurs when the patient's PaO 2 is lower than predicted.
Which of the following is true regarding the PaO 2?
It shows moderate hypoxemia.
Which of the following terms describes an abnormal increase in the proportion of circulating immature neutrophils?
Left shift
Which of the following terms is used for white blood cells?
Leukocytes
Which of the following terms describes an overall abnormal decrease in white blood cell count?
Leukopenia
Which of the following types of white blood cells exists as two types—the B cell and the T cell?
Lymphocyte
Which of the following types of leukocytosis is typically seen in patients with viral infection?
Lymphocytosis
Which of the following terms describes red blood cells that are larger than normal?
Macrocytic
Which of the following types of white blood cells is physically the largest?
Monocyte
Which of the following terms describes the change in white blood cell count that often occurs in patients with tuberculosis?
Monocytosis
Which of the following diseases is characterized by abnormal deep tendon reflexes due to abnormalities of the neuromuscular junction?
Myasthenia gravis
During evaluation of the enzymes, what disorder is associated with elevation of the CK-MB on electrophoresis?
Myocardial infarction
What type of white blood cell typically is most prevalent in the circulating blood?
Neutrophil
Hyperventilation would be observed in a patient who has damaged which portion of the brain stem?
Pons
Hypoalbuminemia may result in what pulmonary problem?
Pulmonary edema
In which of the following conditions would secondary polycythemia not be expected?
Pulmonary embolism
Which of the following is the most common site for arterial puncture?
Radial Artery
Which of the following statements is true regarding the accuracy of the reported results?
The pH is reported considerably higher than it should be.
Which of the following terms is used for blood platelets?
Thrombocytes
For which of the following disorders does a skin test use purified protein derivative (PPD)?
Tuberculosis
A patient has the following ABG results: pH 7.25, PaCO 2 32 mm Hg, HCO 3 - 16 mEq/L, base excess -10 mEq/L Based on these findings, the patient has which of the following?
Uncompensated metabolic acidosis
The acid-base status is classified as which of the following?
Uncompensated respiratory acidosis
Which of the following cranial nerves is intact if cough is present while the airway is suctioned?
X
The most common type of anemia worldwide is the result of:
iron deficiency.
What percentage of circulating white blood cells is made up of neutrophils?
50%-70%
What is the normal value for arterial pH?
7.35 to 7.45
What is the normal value for PaO 2 in the adult patient breathing room air?
80 to 100 mm Hg
Which Glasgow coma scale score is typically an indication for endotracheal intubation?
<9
Which of the following terms is used for red blood cells?
Erythrocytes
A patient with a platelet count of about 80,000/mm 3 is likely to have what condition?
Excessive bleeding
What is often the first clinical sign that suggests the presence of hypoxemia?
Exertional dyspnea
What percentage of normal circulating white blood cells are immature and nonsegmented?
0%-5%
An acute increase in PaCO 2 of 10 to 15 mm Hg causes a corresponding increase in plasma HCO 3 - of how many mEq/L?
1
A patient who is alert and oriented times three would be able to answer which of the following things correctly? 1. First and last name 2. Today's date 3. City in which he or she lives 4. President or head of state's name
1, 2, and 3
Which of the following are important factors in determining the needed frequency of the neurologic assessment? 1. Patient's diagnosis 2. Acuity of the condition 3. How rapidly changes are occurring or are expected to occur 4. Shift change schedule
1, 2, and 3
Which of the following white blood cells are granulocytes? 1. Basophil 2. Eosinophil 3. Neutrophil 4. Lymphocyte
1, 2, and 3
A patient presents with a D-dimer of 210 ng/mL. Which of the following would be a suspected disease process or condition? 1. Streptococcal pneumonia 2. Pleural effusion 3. Pulmonary embolism 4. Tuberculosis
1, 2, and 4
Which of the following are parts of the brain? 1. Cerebrum 2. Cranial nerves 3. Brain stem 4. Cerebellum
1, 3, and 4
What is the normal life span of the neutrophil?
10 days
For the test of collateral circulation in an Allen's test, "pinking up" of the hand is normal if it occurs within ____ s.
10-15
What is the typical life span of a red blood cell?
120 days
What is the normal value for CaO 2?
16 to 20 mL/dL
Which of the following are included in the acronym PERRLA? 1. Positioned 2. Accommodation 3. Round 4. Reactive
2, 3, and 4
Which of the following conditions are known to cause anergy? 1. Chronic hypertension 2. Sarcoidosis 3. Lung cancer 4. Aging
2, 3, and 4
What is the normal percentage of lymphocytes in circulating white blood cells?
20%-45%
Which of the following ratios of HCO 3 -/PaCO 2 results in a pH of 7.40?
20:1
The classic dividing line between transudates and exudates is a protein level of __ g/dL.
3
An arterial puncture site normally should be compressed for a minimum of ___ min after the puncture.
3-5
Which of the following could cause this patient's problem?
Acute airway obstruction
Elevation of troponin is associated with what disorder?
Acute myocardial infarction
Which of the following tests is performed to check the collateral circulation of the radial artery before puncture?
Allen's test
Which of the following terms describes an abnormal decrease in red blood cell count?
Anemia
The brain death determination test involving disconnecting a patient from the ventilator, providing 100% oxygen, and monitoring closely for spontaneous breathing is the __________________.
Apnea test
The presence of dorsiflexion of the great toe with fanning of the remaining toes during testing of the plantar reflex is known as the:
Babinski sign
Which of the following terms describes the immature neutrophil?
Band
Which of the following is the best indicator of metabolic acid-base status?
Base excess
What cells proliferate in patients with leukemia?
Blasts
Before an arterial blood gas (ABG) value is obtained, why should the patient's clotting parameters be evaluated?
Bleeding time may be prolonged if they are abnormal.
Where in the nervous system is breathing regulated?
Brain stem
A 62 year-old male patients is presenting with shortness of breath and has a BNP level of 590 pg/mL. What is his likely diagnosis?
CHF
Which of the following would be best used to assess arterial oxygenation?
CaO2
What is the direct effect of an increased PaCO 2 on HCO 3 -?
Causes it to increase.
Which of the following anatomic areas is compromised when the patient has dysmetria?
Cerebellum
Which of the following is the most critical parameter to keep in mind when managing a patient with intracranial hypertension?
Cerebral perfusion pressure
Which of the following is the largest part of the brain?
Cerebrum
Which of the following respiratory patterns consists of phases of hyperpnea that regularly alternate with episodes of apnea?
Cheyne-Stokes respiration
Given the following ABG results, interpret the acid-base status: pH 7.44, PaCO 2 25 mm Hg, HCO 3 -17 mEq/L, base excess -6 mEq/L
Compensated respiratory alkalosis
Which of the following symptoms is commonly seen with hyponatremia?
Confusion
The main goal of assessing mental status is to determine which of the following?
Consciousness
What disease is associated with elevations in sodium and chloride in sweat?
Cystic fibrosis
A shift to the right in the oxyhemoglobin dissociation curve has what effect on the affinity of hemoglobin for oxygen?
Decreased
Which of the following disorders is associated with hyperglycemia?
Diabetes
A 32-year-old man comes to the emergency department after a traffic accident with the following data: pulse, 118 beats/min; respiratory rate, 27 breaths/min; blood pressure, 100/68 mm Hg; paradoxical chest movement on the left side; breath sounds decreased on the left; and ABG on room air (21%) as follows: pH, 7.32; PaCO 2, 70 mm Hg; PaO 2, 57 mm Hg; HCO 3 -, 23 mEq/L; base excess, 0; SaO 2, 86%, CaO 2, 15.2 vol%; Hb, 13.0 g/dL; P(A-a)O 2, 18 mm Hg. Based on this information, what is the primary cause of the patient's hypoxemia?
Overall hypoventilation
Which of the following would be the best indicator of tissue oxygenation?
PO2
Injury to the cervical spine roots C3 to C5 is associated with which of the following abnormalities?
Paralysis of the diaphragm
Which of the following is a formed element found in circulating blood?
Platelets
Elevation of blood urea nitrogen (BUN) and creatinine levels in the blood suggests what type of problem?
Renal failure
Heavy smokers are prone to what change in the red blood cell count?
Secondary polycythemia
Which of the following is considered the major cation of the extracellular fluid?
Sodium
Which of the following organisms is responsible for most cases of bacterial pneumonia?
Streptococcus pneumoniae
Which of the following is true regarding respiratory alkalosis?
The PaCO 2 is less than 35 mm Hg.
The purpose of performing the sensitivity test on sputum samples is to:
determine the best antibiotic to prescribe.
What defines acidosis in a human?
pH < 7.35
Which of the following is a correct representation of the Henderson-Hasselbalch equation?
pH = pK + log HCO 3 -/(PaCO 2 • 0.03)